Outbreak of e-cigarette–associated acute lipoid pneumonia

10 September 2019

Article: 53/3609

According to the Morbidity and Mortality Weekly Report (MMWR), during July and August 2019, five patients were identified at two hospitals in North Carolina with acute lung injury potentially associated with electronic cigarette (e-cigarette) use.

E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavourings, and other chemicals that users inhale, behaviour commonly referred to as vaping. E-cigarettes can also be used to deliver marijuana and other drugs. In recent months, more than 200 possible cases of acute lung injury potentially associated with vaping have been reported from 25 states in the USA.

The five patients were adults aged 18–35 years and all experienced several days of worsening dyspnea, nausea, vomiting, abdominal discomfort and fever. All demonstrated tachypnea with increased work of breathing on examination, hypoxemia and bilateral lung infiltrates on chest x-ray. All five patients shared a history of recent use of marijuana oils or concentrates in e-cigarettes. All were hospitalised for hypoxemic respiratory failure; three required intensive care for acute respiratory distress syndrome, one of whom required intubation and mechanical ventilation. All of the patients survived but these cases highlight the importance of awareness of a potential association between use of marijuana oils or concentrates in e-cigarettes and lipoid pneumonia. 

Source: MMWR, 6 September 2019